title: Frequency of hyponatremia and nonosmolar vasopressin release in the acquired immunodeficiency syndrome.
abstract: The frequency and pathophysiology of hyponatremia were studied in the acquired immunodeficiency syndrome. Of 71 hospitalized patients surveyed retrospectively, hyponatremia was observed in 37 (52%). Of 48 patients studied prospectively, 27 (56%) were hyponatremic. In 16 hyponatremic patients, volume status; serum and urine osmolalities; renal, adrenal, and thyroid function; and plasma vasopressin levels were assessed. Urine osmolalities were inappropriately elevated (mean, 377 mmol/kg of water) relative to serum osmolalities (mean, 268 mmol/kg of water). Four patients had moderate renal insufficiency. Plasma vasopressin levels were elevated in 15 patients, with the highest levels seen in patients who died (median, 7.08 pmol/L). Hyponatremia of multiple etiologies occurred in a majority of inpatients with the acquired immunodeficiency syndrome, often following the administration of hypotonic fluids, and was associated with a 30% (8/27) short-term mortality.
authors.affiliation: Department of Medicine, Lenox Hill Hospital, New York, NY 10021.
authors.forename: K E
authors.initials: KE
authors.lastname: Vitting
authors.forename: M H
authors.initials: MH
authors.lastname: Gardenswartz
authors.forename: P M
authors.initials: PM
authors.lastname: Zabetakis
authors.forename: M L
authors.initials: ML
authors.lastname: Tapper
authors.forename: G W
authors.initials: GW
authors.lastname: Gleim
authors.forename: M
authors.initials: M
authors.lastname: Agrawal
authors.forename: M F
authors.initials: MF
authors.lastname: Michelis
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000401:mortality / Q000503:physiopathology*; D000328:Adult; D001127:Arginine Vasopressin / Q000097:blood*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007010:Hyponatremia / Q000150:complications / Q000401:mortality / Q000503:physiopathology*; D008297:Male; D009994:Osmolar Concentration; D011446:Prospective Studies; D012189:Retrospective Studies
chemical_list: D001127:Arginine Vasopressin